May 22, 2024

Is it ethical to destroy the capacity for pleasure?

Chinese neurosurgeons are treating opiate addiction by destroying a region of the brain which feels pleasure.

Chinese neurosurgeons are treating opiate addiction by destroying a region of the brain which feels pleasure. But, reports Time magazine, “damaging the brain region involved in addictive desires risks permanently ending the entire spectrum of natural longings and emotions, including the ability to feel joy.”

The idea of destroying parts of the brain as a conventional treatment has outraged many Western doctors. In fact, it was so controversial that China’s Ministry of Health banned it in 2004, although a loophole was left for researchers. Apparently one surgeon drove a truck through the loophole and by 2007 he had done 1,000 of these operations to treat severe depression, epilepsy and schizophrenia.

In October, doctors at Tangdu Hospital at the Fourth Military Medical University in the city of Xi’an, reported the results of neurosurgery for drug addicts — called ablation of the nucleus accumbens — in a major international journal, World Neurosurgery. They found that it was effective, but only in about 58% of addicts – compared to a 30-40% non-relapse rate for conventional treatments. There are also side-effects, although the doctors say that these are relatively minor.

Western doctors are adamant that this operation is unethical. “To lesion this region that is thought to be involved in all types of motivation and pleasure risks crippling a human being,” says Dr Charles O’Brien, head of the Center for Studies of Addiction at the University of Pennsylvania. David Linden, of Johns Hopkins, calls the surgery “horribly misguided.”

Time raised a number of ethical concerns. First, animal studies suggest that the ablation of the nucleus accumbens did not stop the craving for opioids. Second, there may be a lack of informed consent. Drug addiction is a capital crime in China and patients may be clutching at straws to stay out of the courts. Third, publishing the results of unethical research may itself be unethical.

Finally, the risks seen to outweigh the benefits. While the operation might be acceptable for long-term addicts, a recent article mentioned that some patients were only 19 and had been addicts for only 3 years. “Addiction research strongly suggests that such patients are likely to recover even without treatment, making the risk-benefit ratio clearly unacceptable.”  

MIchael Cook
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